{"created":"2023-05-15T09:08:54.424657+00:00","id":16597,"links":{},"metadata":{"_buckets":{"deposit":"b5ffda9e-a5fd-4f01-a038-747d0a5e0d29"},"_deposit":{"created_by":14,"id":"16597","owners":[14],"pid":{"revision_id":0,"type":"depid","value":"16597"},"status":"published"},"_oai":{"id":"oai:sapmed.repo.nii.ac.jp:00016597","sets":["1875:1909:2209"]},"author_link":["33427","33428","33429","33430","33423","33424","33425","33426"],"item_5_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2017-07-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"62","bibliographicPageStart":"60","bibliographicVolumeNumber":"25","bibliographic_titles":[{"bibliographic_title":"名寄市立病院医誌"}]}]},"item_5_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"当院集中治療室(以下ICUと略す)は,Open ICUとして運営されているため,気管挿管患者に対する鎮痛•鎮静方法やリハビリの介入,抜管基準などは各診療科,各医師により様々である。現在,J-PADガイドライン1> によるPADケアバンドルの実践により鎮痛•鎮静•せん妄の管理がなされ,ベッドサイドでのリハビリ介入もされていることが多いが,離床するのは抜管後,または退室してからがほとんどである。鎮静を浅くすると不穏状態となることもあり,安全確保のため身体抑制を施行せざるを得なくなることが理由の1つである。そのため,鎮静をやや深めにし,身の回りのことは看護師が全て援助している傾向にある。近年,ICU-AW (ICU-acquired weakness)や,ICU-AD(ICU-acquirecl delirium)の病態が明らかとなり,患者の短期的な生命予後悪化に関連しているだけではなく,生存患者においても長期間にわたって認知機能や身体機能の障害を残すとされている。これらに対しABCDEバンドル2>が提言されたが,ICU内での認知度は低く,意識して実践するには至っていない。また,人工呼吸器離脱に関しては救急科医師と共に検討し定めたプロトコル3>があるが,全診療科での使用はされていない。本稿では,PADケアバンドルと人工呼吸器離脱プロトコルを実践し,気管挿管下で離床をすすめた症例を報告する。","subitem_description_type":"Abstract"}]},"item_5_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"33427","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Hiroko, Nagaiif"}]},{"nameIdentifiers":[{"nameIdentifier":"33428","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Yuuki, Tari"}]},{"nameIdentifiers":[{"nameIdentifier":"33429","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Hiromi, Orita"}]},{"nameIdentifiers":[{"nameIdentifier":"33430","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Akihito, Tampo"}]}]},"item_5_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"名寄市立病院"}]},"item_5_version_type_15":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"永井, 紘子"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"田利, 優來"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"折田, 博美"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"丹保, 亜希仁"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2020-04-16"}],"displaytype":"detail","filename":"n1340274925160.pdf","filesize":[{"value":"1.7 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"n1340274925160.pdf","url":"https://sapmed.repo.nii.ac.jp/record/16597/files/n1340274925160.pdf"},"version_id":"7b3c7c6a-cc9e-400a-b022-041ba56adae0"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"気管挿管患者","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"早期離床","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"PADケアバンドル","subitem_subject_language":"ja","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"technical report","resourceuri":"http://purl.org/coar/resource_type/c_18gh"}]},"item_title":"気管挿管患者の早期離床と今後の課題","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"気管挿管患者の早期離床と今後の課題","subitem_title_language":"ja"},{"subitem_title":"Early mobilization in intubated patients and upcoming tasks","subitem_title_language":"en"}]},"item_type_id":"5","owner":"14","path":["2209"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2020-04-16"},"publish_date":"2020-04-16","publish_status":"0","recid":"16597","relation_version_is_last":true,"title":["気管挿管患者の早期離床と今後の課題"],"weko_creator_id":"14","weko_shared_id":-1},"updated":"2023-06-20T01:41:29.646025+00:00"}